ExcelleMD is proud to offer phlebology services.
Call us now at 450-735-8111, poste 5242.
Phlebology is a branch of medicine devoted to the study of conditions affecting the veins, in particular venous insufficiency and varicose problems localized in the lower limbs. A phlebologist is a trained physician who assesses, performs physical and ultrasound examinations, makes diagnoses, and administers treatments for venous problems.
Venous insufficiency occurs when the veins have health problems and can no longer effectively perform their role, which is to circulate blood from the extremities to the heart. This condition is widespread and has seen a significant increase in our knowledge in recent years. It has been proven that this disease is chronic and progressive, hence the importance of early detection and rapid intervention to prevent serious long-term complications.
Certain risk factors predispose to the development of this disease:
- Age > 40 years old
- Being a woman
- The pregnancy
- Abdominal obesity
- A history of thrombophlebitis
- Trauma (contusion/fracture)
- Standing static work
The signs and symptoms that can result from venous insufficiency of the lower limbs are vast and often unrecognized. Here are the main ones where you might benefit from a phlebology evaluation:
- Varicose vein (dilated and bulging vein, often tender)
- Varicosity (any small red or blue vein on the surface of the skin)
- Ankle edema
- Night cramps
- restless legs
- Itching and change in skin color
- Ulcer or sore that heals poorly
Sclerotherapy is currently the most frequently used treatment in the field. It is a safe, effective, painless, minimally invasive, affordable method that does not require any convalescence. Sclerotherapy consists of injecting a drug (liquid or foam) directly into the affected vein using a needle. This creates spasm, inflammation and ultimately scarring inside the diseased vein in an attempt to close it permanently. Thus, the blood circulating there will take the path of one of the many other normal veins to go back to the heart.
Initially, a few treatment sessions (on average 3-4), lasting about 20 minutes and spaced out every 4-6 weeks are generally necessary in order to optimize the results. The approximate treatment plan will be offered to you by the doctor during the evaluation. It is important to know that symptoms can be quickly relieved after a sclerotherapy session, while visual improvement will occur more gradually. Since varicose disease is chronic, it is normal for other varicose veins or spider veins to form over time. An annual check-up appointment could be suggested to you so that you do not have to resume the entire treatment after a few years.
Other types of treatment are sometimes indicated depending on the severity of venous insufficiency and a person’s medical condition. These are endovascular techniques (laser or radiofrequency) and surgery. During the evaluation, the doctor will discuss the options that apply to you and refer you if necessary.
The most common side effects of sclerotherapy are bruising and tenderness/induration of the treated vein due to the inflammation created there. When present, these disappear in less than 10 days. Other mild reactions may occur either:
- Cutaneous hyperpigmentation (10-30%) – 99% of which will have disappeared spontaneously after 6-12 months.
- The “matting” or appearance of new telangiectasias (10-15%) – will disappear in 3-6 months, otherwise can be treated at the next appointment
- Transient neurological symptoms such as headache or blurred vision (1-2%)
- Thrombophlebitis (< 1:1000)
- More serious reactions such as a pulmonary embolism or an allergic reaction are extremely rare.
For the 2 weeks post-treatment, a few simple instructions should be followed in order to limit the occurrence of adverse effects:
- Wearing 20-30mmHg compression stockings on the knees (minimum 2 weeks, ideally every day)
- Taking acetaminophen as needed/li>
- Walk at least 30 minutes a day
- Avoid heavy lifting and impact activities
- Avoid hot baths and direct exposure to sunlight
- Avoid long periods of downtime, especially air travel
Dr. Karine Turcotte, graduated from the DMFMU (Department of Family Medicine and Emergency Medicine) of the Université de Sherbrooke in 2009, practiced 5 years in the emergency room and now has more than 13 years of experience in hospital medicine at the St-Eustache hospital.
Since 2014, she has been teaching family medicine to residents of the Université de Montréal at the Saint-Eustache Family Medicine Unit. She also developed a field of interest in musculoskeletal infiltration techniques. Subsequently, Dr. Turcotte perfected her skills in phlebology and obtained her certificate of practice from the Collège des médecins du Québec. Her mentors are Dr. Pauline Martimbeau and Dr. Michel Zummo, both internationally renowned and pioneers in phlebology in Quebec.
Dr. Turcotte’s passion for phlebology led her to join the ExcelleMD team in order to provide quality care based on the most recent practice guidelines while prioritizing the comfort and confidence of her patients.